Information Collection

Claims And Appeals

IC 161874 under ICR 198701-9000-013 · OMB 9000-0035.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 9000-0035 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	CLAIMS AND APPEALS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	150,000	142,000	8,000
Annual IC Time Burden (Hours)	150,000	142,000	8,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.